Firstly, a bit about you.  So that we can make sure the results of this survey are representative of everyone could you please let us know:

Your title, First name, Surname

Date of Birth

Address & postcode

Telephone/mobile number

Email address



Your responses and contact details are used in accordance with our Data Collection and Use policy. By clicking "submit" you agree to your responses and email address being used in accordance with that policy. We will not share your details with anyone outside the Conservative Party.